Far lateral supracerebellar infratentorial approach for the treatment of upper brainstem gliomas:: clinical experience with pediatric patients

Objective: Surgical exposure of intrinsic lesions located lateral to the brainstem still represents a challenging task. The aim of this study was to assess the feasibility of the extracerebral far lateral supracerebellar infratentorial (FLSI) approach for the treatment of gliomas located in the upper brainstem in the pediatric population. Methods and results: Between 1992 and 2002, seven patients (mean age 8.7 years) with tumors of glial origin (WHO I-IV) located mainly in the pontomesencephalic region were operated with the FLSI approach in a sitting position. Satisfactory extent of resection without additional morbidity was achieved. Conclusion: In a carefully selected pediatric patient population, the FLSI approach proved to be a feasible and effective surgical route for the treatment of upper brainstem gliomas.